Prefrontal White Matter Lesions and Prefrontal Task Impersistence in Depressed and Nondepressed Elders

Abstract

Poor task persistence is often observed among depressed individuals, and may be associated with some of the same frontal regions that are involved in depression. The current study explored the association between white-matter lesion volume in prefrontal cortex and noncompletion rates on a complex neurocognitive task among older adults in a treatment study for depression. Older adults in treatment for depression (n ¼ 83) and nondepressed (n ¼ 47) elders were administered the Stockings of Cambridge subtest (SoC) of the Cambridge Automated Neuropsychological Testing Battery (CANTAB) and completed a brain magnetic resonance imaging scan as part of an ongoing research study. Noncompletion of the SoC occurred in approximately 19% of depressed participants (16/83) and only 2% of nondepressed participants (1/47), which was statistically significant. In multivariate models, failure to complete the SoC was consistently and significantly associated with greater volume of white matter lesions in the anterior-most region of prefrontal cortex, particularly in the left hemisphere, and with greater age. Although SoC completion was not significantly associated with depression severity, noncompletion rates were significantly higher among unremitted individuals and those with comorbid anxiety at study entry. The inability to initiate behavior sufficient to sustain a complex neurocognitive task is a characteristic of geriatric depression which may be associated with integrity of left-prefrontal regions. Future research should investigate whether task impersistence is a construct that generalizes to other neurocognitive tasks, and if it is associated with other adverse outcomes in geriatric depression related to cerebrovascular pathology, such as poor treatment response.

Shortened telomere length in white matter oligodendrocytes in major depression: potential role of oxidative stress

“…White matter pathologies have been demonstrated using either neuroimaging methods in living MDD patients or post-mortem tissues from MDD donors (Tham et al, 2011). For example, white matter hyper-intensities on MRI scans are more prevalent in patients with MDD (Nobuhara et al, 2006;Potter et al, 2007;Taylor et al, 2007;Köhler et al, 2010;Tham et al, 2011). Low expression of multiple oligodendrocyte genes has been shown in post-mortem temporal cortex from MDD donors (Aston et al, 2005).…”

A “virtually minimal” visuo-haptic training of attention in severe traumatic brain injury

“…The launch phase (before any feedback has yet arrived) appears to be completely interrupted on some patients’ motions, suggesting that this so-called ballistic phase may be much less automatic and uninterruptable than has been originally assumed. Such observed mid-movement pauses may also be associated with the neurological disorder of task impersistence , which is a failure to re-initiate activity without receiving immediate reward [40] and is associated with frontostriatal dysfunction [41]. The observed pauses during movements might be explained either by attentional or motor control deficits also sometimes observed in these patients.…”

Differential Patterns of Cognitive Decline in Anterior and Posterior White Matter Hyperintensity Progression

“…Additional procedures were required to obtain measures of WMH and volume of the cerebrum in anterior and posterior brain areas (Figure 1), and have been described previously 14 . First, an axial plane was created along the anterior -posterior commissural line, dividing superior regions from inferior.…”